الفهرس 
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Abstract
Irritable bowel syndrome (IBS) is a functional bowel disorders (FBD) characterized by chronic recurrent abdominal pain and alterations in bowel habits, unrelated to organic causes. Onset of symptoms should start at least 6 months before diagnosis. Low-grade intestinal inflammation plays a key role in the pathophysiology of IBS, which is likely multifactorial. Thus, the risk of developing IBS was increased after infectious gastroenteritis. Furthermore, increased intestinal permeability has also been observed in patients with overt gut inflammation and in patients with diarrhea-predominant IBS and post infectious IBS; both of which are associated with subtle, low-grade inflammation of the small bowel.
Eosinophils are present in the healthy intestinal mucosa, but their recruitment from the blood is increased throughout inflammatory conditions. The distinction between the upper limit of normal and abnormally increased colonic mucosal eosinophils is not well defined. However, eosinophils that infiltrate the epithelium and coalesce to form aggregates, or show extensive degranulation are considered abnormal. Binding of IgE to receptors on the surfaces of esinophils cause their degranulation and release of their mediators which significantly correlated with IBS clinical severity. Furthermore, mucosal eosinophils displayed higher degranulation profile in IBS-D as compared to healthy control. It is observed that patients with atopic conditions report more GIT symptoms compared with non-atopic ones.
We studied the association between colonic mucosal eosinophilia and serum level of total IgE in patients with IBS.
The study was conducted on 80 patients who met the inclusion criteria. Patients were subjected to thorough clinical examination, basic laboratory investigations, abdominal ultrasonography, stool analysis, colonoscopy with biopsy and then histopathological examination were done.
Here in this study, 80 patients diagnosed as IBS according to Rome IV symptoms questionnaire. They were 57 (71.25%) females and 23 (28.75%) males. Their mean ages were 34.6± 9. And, 48 (60.00%) patients were IBS- D subtype, 19 (23.75%) patients were IBS-C subtype, 9 (11.25%) patients were IBS-M subtype and 4 (5.00%) patients were IBS-U subtype. Colonoscopy results showed 70 (87.5%) patients had normal colonic mucosa. Whereas, 10 (12.5%) patients had only mild hyperemic mucosa.
Histopathological results:
1- 60 (75%) biopsy specimens showed few mixed inflammatory cells (eosinophiles ≤ 3/ HPF, lymphocytes, plasma celles and macrophages), which was considered as normal finding.
2- 12 (15%) biopsy specimens showed eosinophilic infiltration and aggregation ≥ 10 eosinophiles/ HPF or showed extensive degranulation.
3- 8 (10%) biopsy specimens showed severe lymphocytic infiltration and aggregation, these biopsies most probably considered as a microscopic colitis.
In addition, this study showed that there is no significant correlation between colonic mucosal eosinophilic infiltration in IBS patients and presence of allergic diseases, (P=0.2). In addition, here in this work, we founed that patients with IBS- D subtype showed significantly higher incidence of colonic mucosal eosinophilic infiltration when compared to other subtypes (P=0.002). Adding together here in this work, we founed that there is no significant correlation between high serum IgE levels and colonic mucosal eosinophilic infiltration (P =0.2).
Adding up in this work, we founed also, there is no correlation between high peripheral eosinophilia and colonic mucosal eosinophilic infiltration (P = 0.1).